目的 探討不同吸煙狀況肺癌患者的臨床特點、治療療效和生存的差異。方法 分析1992 年至2001 年10 年間收治的3751 例肺癌病例, 研究非吸煙者肺癌及吸煙者肺癌病例臨床資料,比較兩組肺癌病例在年齡、性別、病理類型、分期、治療情況和近期療效及生存等方面的差異。結(jié)果 吸煙者肺癌2545 例( 67. 8% ) , 非吸煙者肺癌1206 例( 32. 2% ) 。男性肺癌80. 3% 為吸煙者, 女性10. 5%為吸煙者。不同病理類型中以鱗癌的吸煙率最高83. 7% ( 1347 /1609) , 其次為小細(xì)胞肺癌75. 1%( 373/497) 。非吸煙者肺癌的女性比例、腺癌、第二原發(fā)癌比例、進(jìn)展期比例、采用非手術(shù)治療等方面明顯高于吸煙者肺癌; 吸煙者肺癌伴隨慢性支氣管炎、肺結(jié)核、鱗癌比例和采用手術(shù)治療等高于非吸煙者肺癌?？傮w比較兩組的近期療效和總生存率無差異。結(jié)論 吸煙和非吸煙者肺癌在臨床特點和治療方式等存在差異, 但生存情況無差異。對于肺癌病例, 根據(jù)患者的吸煙狀況不同應(yīng)該采取不同的診斷和治療手段。
引用本文： 方美玉,姜初明,趙亞珍,鄭亞兵,馬勝林. 無吸煙史肺癌與吸煙相關(guān)肺癌臨床比較. 中國呼吸與危重監(jiān)護(hù)雜志, 2010, 9(2): 177-180. doi: 復(fù)制
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- 1. Doll R, Hill AB. Smoking and Carcinoma of the Lung; preliminary report. Br Med J, 1950, 2 : 739-748.
- 2. Wakelee HA, Chang ET, Gomez SL, et al. Lung cancer incidence in never smokers. J Clin Oncol, 2007, 25: 472 -478.
- 3. 景霞, 許建英. 吸煙對大鼠氣道上皮細(xì)胞基質(zhì)金屬蛋白酶9 表達(dá)的影響. 中國呼吸與危重監(jiān)護(hù)雜志, 2009, 8: 220-223.
- 4. Sardari Nia P, Weyler J, Colpaert C, et al. Prognostic value of smoking status in operated non-small cell lung cancer. Lung Cancer,2005, 47: 351 -359.
- 5. Shriver SP, Bourdeau HA, Gubish CT, et al. Sex-specific expression of gastrin-realing peptide receptor-relationship to smoking history and risk of lung cancer. J Natl Cancer Inst, 2000 , 92: 24-33.
- 6. Van Rens MT, de la Rivière AB, Elbers HR, et al. Prognostic assessment of 2 , 361 patients who underwent pulmonary resection for non-small cell lung cancer, Stage I, II, and IIIA. Chest, 2000, 117 :374-379.
- 7. Thatcher N, Chang A, Parikh P, et al. Gefitinib plus best supportive care in previously treated patients with refractory advanced non-smallcell lung cancer: results from a randomized, placebo-controlled,multicentre study ( Iressa Survival Evaluation in Lung Cancer ) .Lancet, 2005 , 366: 1527 -1537 .
- 8. Shepherd FA, Rodrigues Pereira J, Ciuleanu T, et al. Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med, 2005 ,353: 123-132 .